WHO plans to increase access to affordable, quality-assured diabetes tests and treatments

reviewed by Emily Henderson, Bachelor of ScienceSeptember 26, 2020

During a four-day workshop that ended on September 25, 2020, WHO and key international health partners devised a plan to drive access to affordable, quality-assured diabetes tests and treatments.

There are more than 420 million people living with diabetes. Diabetes is the seventh leading cause of death and one of the leading causes of costly and debilitating complications such as heart attacks, strokes, kidney failure, blindness, and lower limb amputations.

People with type 1 diabetes need insulin to survive. However, many of the low- and middle-income countries do not receive it, largely due to high prices and supply problems.

People with type 2 diabetes need insulin to control blood glucose levels and avoid complications when oral medications become less effective in the progressive course of the disease. About 60 million people with type 2 diabetes need insulin, but only half of them can access it.

One problem with insulin costs is that three parent companies control 96% of the world market and set prices prohibitive for many countries. In addition, insulin delivery devices and glucose meters to monitor blood sugar levels are lacking or in short supply in many countries.

It is a failure of society and the global community as a whole that people who need insulin have financial difficulties to buy or do without it and risk their lives. ”

Dr. Tedros Adhanom Ghebreyesus, Managing Director, who

WHO has been working on a special focus package of measures to address the growing burden of diabetes in all countries. In November 2019, the WHO launched an insulin prequalification pilot to ensure the quality of more insulin products entering the international market, giving countries more options and potentially lower prices, thus contributing to better access.

There are many different stakeholders working on insulin and this week’s WHO workshop was an initial effort to bring all the workflows together for greater impact at the country level.

Bringing together all stakeholders, including regulators, civil society and UN partners, the workshop highlighted opportunities to change the game and do things differently through:

• global partnerships and patient-centered approaches
• better gauge the global impact of diabetes and improve the coverage and quality of diagnosis
• expand access to essential diabetes medicines, including insulin and associated devices (i.e. insulin delivery devices, blood glucose meters, and test strips)
• increased advocacy to raise awareness of the continuing challenges in accessing insulin, even as we approach the centenary of its discovery.
• better training of health professionals.
• agreement on an overall treatment goal for diabetes, including% of people diagnosed,% of people on treatment, and% of insulin.

Fast facts:

• Diabetes is a global epidemic. Today, more than 420 million people are living with diabetes around the world. This is 6% of the world’s population. It is also four times more than in 1980. This number is estimated to increase to 570 million by 2030 and 700 million by 2045.
• 1 in 2 adults with diabetes does not know their status. 4 out of 5 adults with undiagnosed diabetes live in low- and middle-income countries. People who are unaware of their condition are at great risk for debilitating complications.
• All people with type 1 diabetes need insulin. Sixty million people with type 2 diabetes also need insulin, but about half of them cannot get the insulin they need because health systems in their country cannot afford it.
• This year’s WHO Global Capacity Survey on NCDs reveals that less than half of low-income countries have general availability of insulin in the public sector.
• Last year’s WHO Universal Health Coverage Monitoring Report shows that NCD services stand out for their lack of progress compared to communicable diseases.
• The prevention, screening, early diagnosis and appropriate treatment of diabetes and other NCDs were considered a priority by WHO Member States in 2000, following a call to action by the World Health Assembly, but during the For the past two decades, WHO has had to report to the World Health Assembly that there is not enough progress in countries to meet the health care needs of people living with diabetes.
• At this crucial time, with COVID-19 still spreading, many people in need of diabetes treatment are not receiving the health services and medications they need. A recent survey by WHO found that 50% of countries had discontinued their services due to diabetes and diabetes-related complications.
• People with diabetes are also at increased risk of severe illness and death from COVID-19, and this poor prognosis appears to increase with advancing age. An early clinical evaluation is warranted to detect any suspicious symptoms.
• With the launch of the WHO Operational Guidance for Maintaining Health Services in the Context of COVID-19 in June, WHO provides guidance on how to modify diabetes care for safe service delivery and how to transition to restoration.